Importance and management of micronutrient deficiencies in patients with Alzheimer\u27s disease

Alzheimer\u27s disease (AD) is the most common form of dementia, and it generally affects the elderly. It has been suggested that diet is an intensively modifiable lifestyle factor that might reduce the risk of AD. Because epidemiological studies generally report the potential neuronal protective effects of various micronutrients, the aim of this study was to perform a literature review on the major nutrients that are related to AD, including selenium, vitamins C and E, transition metals, vitamin D, B-complex vitamins, and omega-3 fatty acids

Assessment of zinc nutritional status of the patients undergoing to bariatric surgery (Roux-en-Y gastric bypass)

A prevalência da obesidade está aumentando de forma alarmante em todo o mundo. A obesidade mórbida está entre as doenças que mais matam e o índice de mortalidade entre homens obesos mórbidos de 25 a 40 anos é doze vezes maior em relação a indivíduos com peso normal. Da mesma forma que aumenta o número de obesos, também está havendo um aumento na realização de cirurgias para redução de peso. Além disso, alguns estudos mostram que o estado nutricional relativo ao zinco em indivíduos obesos e diabéticos é alterado. Dessa forma, o objetivo deste trabalho foi avaliar os efeitos da gastroplastia com derivação em Y de Roux sobre o estado nutricional relativo ao zinco de obesos mórbidos. Participaram do estudo pacientes submetidos ao procedimento cirúrgico, perfazendo um total de 24 (vinte e quatro) indivíduos na primeira fase e 22 (vinte e dois) na segunda fase da pesquisa. Foram coletadas amostras de sangue, urina de 24 horas e registros alimentares de três dias (sendo um dia de final de semana) tanto no pré-operatório (T0) quanto aproximadamente dois meses após a cirurgia (T1) - período no qual os pacientes não receberam suplementação de minerais. As amostras biológicas foram analisadas por meio de um espectrofotômetro de absorção atômica de chama e o consumo alimentar de zinco foi analisado por meio do software Virtual Nutri versão 6.0 (FSP/USP). Os resultados no T0 e T1 foram respectivamente: zinco plasmático: 68 e 66,3 µg/dL; zinco eritrocitário: 36,6 e 43,8 µg/gHb; excreção urinária: 884,7 e 385,9 µg/24h e consumo alimentar de zinco: 10,5 e 6,7 mg/dia. Analisando os resultados, pode-se concluir que, num primeiro momento, a distribuição corporal do zinco melhorou, com redução na excreção urinária e aumento nas concentrações eritrocitárias. Entretanto, percebe-se também que o consumo alimentar de zinco apresentou uma redução significativa, o que em longo prazo, pode acarretar maiores problemas aos pacientes caso estes não recebam suplementação adequada.The prevalence of obesity is increasing worldwide. Morbid obesity is a life threatening disease and the mortality index between morbid obese men aged 25 - 40 years is twelve - fold higher in relation to normal body weight subjects. Currently, the employment of surgery for weight reduction has also risen. Furthermore, previous research has shown that the nutritional zinc status in obese and diabetics subjects is altered. Thus, the aim of this study was to assess the influence of the Roux-en-Y gastric bypass on the zinc nutritional status of the morbid obese patients. Twenty four morbid obese individuals were studied before and 22 (twenty two) patients were studied two months after this surgical procedure, the period in which the patients were still not ingesting mineral supplements. Fast blood sample and three days food records were collected in the pre and post - operative phases. The zinc concentration in the sample was analyzed by flame atomic absorption spectrophotometry and dietary analysis of the food records performed using the software Virtual Nutri with the inclusion of zinc concentration in the database for regional foods (School of Public Health - USP - Brazil). The results on the pre and post - operative were respectively, plasma: 68 and 66,3 µg/dL; erythrocytes: 36,6 and 43,8 µg/gHb, urine: 884,7 µg/24h and 385,9 µg/24h and zinc intake: 10,5 e 6,7 mg/day. These results suggest that the surgical procedure changed mainly the zinc erythrocyte concentrations and zinc urinary excretion and, as expected, the zinc intake was lower in the post - operative state, which in the medium and long term, could cause problems for the patients

Effects of the supplementation with Brazil nut (Bertholletia excelsa H.B.K.) on the oxidative stress in obese women and its relation with the Pro198Leu polimorphism in the glutathione peroxidase 1 gene

Indivíduos obesos apresentam níveis elevados de estresse oxidativo quando comparados com controles de peso eutrófico. Isto pode ser atribuído a uma série de fatores, com destaque para a ingestão reduzida de substâncias antioxidantes. Outro aspecto a ser considerado é a presença de polimorfismos em genes que codificam para enzimas antioxidantes, como é o caso do Pro198Leu no gene da enzima glutationa peroxidase 1 (GPx 1). Portanto, este trabalho teve como objetivos estudar as relações entre obesidade, marcadores de estresse oxidativo e o polimorfismo Pro198Leu no gene da GPx1, além de verificar as respostas destes parâmetros à ingestão de castanhas-do-brasil como fonte de selênio (Se). Participaram do estudo 37 mulheres em idade reprodutiva, que não apresentavam diabetes mellitus, doenças da tireóide; não ingeriam suplementos de minerais e vitaminas, medicamentos para redução de peso ou hipolipemiantes, e não eram tabagistas. Foram utilizados os seguintes marcadores bioquímicos: concentrações de Se plasmático, eritrocitário e nas unhas; atividade eritrocitária total da GPx; concentrações urinárias de 8-isoprostanos; concentrações plasmática de TBARS; avaliação de danos em DNA; perfil lipídico sérico; além da determinação dos genótipos relativos àquele polimorfismo. Cada unidade de castanha forneceu, em média, 290 &#181;g do mineral. Na fase pré-suplementação, 100% das pacientes estavam deficientes em Se. As concentrações eritrocitárias (60,5±22,6 x 205,9±42,0 &#181;g/L; p=0.000) e plasmáticas (55,7±13,3 x 132,5±34,9 &#181;g/L; p=0.000) deste mineral aumentaram significativamente na fase pós-suplementação. O mesmo perfil foi observado para a atividade eritrocitária total de GPx (36,6±17,1 x 53,6±20,4 U/gHb; p=0.000) e para as concentrações plasmáticas de TBARS (5,0±3,7 x 7,6±3,3 &#181;mol/L; p=0.000). As concentrações urinárias de 8-isoprostanos não apresentaram alterações significativas após a ingestão das castanhas (25,1±14,2 x 21,8±15,6 ng/mmol creat.). E o mesmo ocorreu com os níveis de danos em DNA (77,3±21,6 x 72,2±28,1 &#181;m). Com relação ao perfil lipídico sérico, não foram observadas mudanças significativas nas concentrações de colesterol total (171,0±28,8 x 175,5±26,6 mg/dL), LDL-c (114,0±29,6 x 109,3±22,8 mg/dL), VLDL-c (19,6±9,4 x 21,7±8,3 mg/dL) e triacilgliceróis (110,3±87,9 x 108,6±41,5 mg/dL). Entretanto, as concentrações de HDL-c apresentaram elevação significativa após o consumo das castanhas (37,6±13,6 x 44,5±13,4 mg/dL; p<0.00001). Este aumento também promoveu uma redução significativa nos valores dos índices de Castelli I (5,0±1,8 x 4,2±1,1; p<0.0002) e II (3,4±1,7 x 2,7±1,0; p<0.0004), preditores do risco cardiovascular. A frequência dos genótipos foi de 48,7% para Pro/Pro, 37,8% para Pro/Leu e 13,5% para Leu/Leu. Não foram verificadas diferenças estatisticamente significativas nos níveis de Se e na atividade da GPx entre os genótipos, nas duas fases. Entretanto, houve correlação positiva entre as concentrações eritrocitárias de Se e a atividade da GPx em ambas as fases apenas para o grupo Pro/Pro. Os resultados obtidos no ensaio do cometa foram significativamente diferentes entre os genótipos e revelaram que participantes Pro/Pro apresentaram redução na quantidade de danos em DNA após a ingestão das castanhas, o que não ocorreu naquelas Pro/Leu e Leu/Leu agrupadas. Além disso, aquelas Leu/Leu apresentaram valores de danos significativamente maiores em relação às Pro/Pro. As alterações observadas nos níveis de TBARS e lipídeos séricos não foram relacionadas aos genótipos. Também não foram verificadas alterações nas concentrações urinárias de 8-isoprostanos entre os diferentes genótipos. Estes dados sugerem um efeito benéfico do consumo de castanha-do-brasil como fonte de Se e também de ácidos graxos mono e poliinsaturados. Demonstrou-se também a influência do polimorfismo Pro198Leu no gene que codifica para a GPx1 sobre as concentrações sanguíneas de Se e a atividade eritrocitária total da GPx. Pode-se concluir que há uma interação entre este polimorfismo e o status de Se, bem como dos níveis antioxidantes.Obese subjects present high oxidative stress levels when compared to those with normal weight. This characteristic can be attributed to several factors, mainly the low intake of antioxidant compounds. Another aspect to be taken into account is the presence of polimorphisms in genes of antioxidant enzymes, such as the Pro198Leu in the glutathione peroxidase 1 (GPx1) gene. The objectives of this work were to study the relations among obesity, oxidative stress markers, and the GPx1 Pro198Leu polymorphism, and to verify the responses of these parameters to the intake of Brazil nuts as a selenium (Se) source. Thirty seven women in reproductive age have participated in the study. They did not present diabetes mellitus, thyroid diseases, intake of vitamins and minerals supplements, medicines for weight loss or for cholesterol levels management, and smoking habit. The following biochemical markers were determined: plasma, erythrocyte and nails Se concentrations; total erythrocyte GPx activity, urine 8-isoprostanes concentration; plasma TBARS concentration; DNA damage; serum lipid profile; and genotyping of the polymorphism. Each unit of Brazil nut was estimated to provide &#8776; 290 &#181;g of Se. In the pre-supplementation phase, 100% of the subjects presented Se deficiency. The erythrocyte (60.5±22.6 x 205.9±42.0 &#181;g/L; p=0.000) and plasma (55.7±13.3 x 132.5±34.9 &#181g/L; p=0.000) concentrations of this mineral had presented a significant raise in the post-supplementation phase. The same profile was observed for the GPx activity (36.6±17.1 x 53.6±20.4 U/gHb; p=0.000) and for the plasma TBARS (5.0±3.7 x 7.6±3.3 &#181;mol/L; p=0.000) concentrations. There were no significant changes in the urinary 8-isoprostanes (25.1±14.2 x 21.8±15.6 ng/mmol creat.) concentration. The same pattern was observed in relation to the DNA damage levels (77.3±21.6 x 72.2±28.1 &#181;m). Regarding the serum lipid profile, it was not found significant changes in the total cholesterol (171.0±28.8 x 175.5±26.6 mg/dL) concentrations, LDL-c (114.0±29.6 x 109.3±22.8 mg/dL), VLDL-c (19.6±9.4 x 21.7±8.3 mg/dL) and triglycerides (110.3±87.9 x 108.6±41.5 mg/dL). However, there was a significant increase in the HDL-c (37.6±13.6 x 44.5±13.4 mg/dL; p<0.00001) concentrations after the Brazil nuts intake. This increase also had promoted a significant reduction in the Castelli I (5.0±1.8 x 4.2±1.1; p<0.0002) and II (3.4±1.7 x 2.7±1.0; p<0.0004) indexes, which are predictors of cardiovascular risk. The genotype frequency was 48.7% for Pro/Pro, 37.8% for Pro/Leu, and 13.5% for Leu/Leu. Se levels and GPx activity were not significantly different between the genotypes, in both pre and post-supplementation phases. However, there was a positive correlation between Se erythrocyte concentrations and GPx activity in both phases only in the Pro/Pro group. The results from the comet assay were significantly different between the genotypes and showed that subjects who were Pro/Pro presented a reduction in the levels of DNA damage after the Brazil nuts intake, which did not happen in those Pro/Leu and Leu/Leu grouped. Moreover, the Leu/Leu group showed higher damage levels when compared to that Pro/Pro. The changes in the plasma TBARS levels and in the serum lipid profile were unrelated to the genotypes. The urinary 8-isoprostanes concentrations also did not present any change regarding the genotypes. The data suggest a beneficial effect of the Brazil nut intake as a source of Se and possibly of mono and polyunsaturated fatty acid. The influence of the GPx1 Pro198Leu polymorphism on the blood Se concentration and GPx activity could be demonstrated. It could be concluded that there is an interaction between that polymorphism and the Se status, as well as the antioxidant levels

Brazilian Society for Food and Nutrition position statement: nutrigenetic tests

Abstract Position statement: The Brazilian Society for Food and Nutrition (SBAN) bases the following position statement on a critical analysis of the literature on nutritional genomics and nutrigenetic tests: (1) Nutrigenetic tests are predictive and not diagnostic, should not replace other evaluations required to treatment, and should only be used as an additional tool to nutritional prescription; (2) Nutritionists/registered dietitians and other health professionals must be able to interpret the nutrigenetic tests and properly guide their patients, as well as build their professional practice on general ethical principles and those established by regulatory authorities; (3) It is extremely important to highlight that the misinterpretation of nutrigenetic tests can cause psychological and health problems to the patient; (4) Currently, there is insufficient scientific evidence for the recommendation of dietary planning and nutritional supplementation based only on nutrigenetic tests. This position statement has been externally reviewed and approved by the board of SBAN and has not gone through the journal’s standard peer review process

Brazilian nut consumption improves selenium status and glutathione peroxidase activity and reduces atherogenic risk in obese women

Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women. Thirty-seven severely obese women each consumed 1 Brazilian nut a day (290 mu g of Se a day) for 8 weeks. Blood Se concentrations, total erythrocyte glutathione peroxidase activity, lipid profile, and Castelli I and H indexes were evaluated before and after the nuts consumption. All the patients were Se deficient at baseline; this deficiency was remedied by the consumption of the Brazilian nut (P &lt; .0001). The intake of Brazilian nuts promoted a significant increase in high-density lipoprotein cholesterol concentrations (P &lt; .00001), which then resulted in a significant improvement of the Castelli I (P &lt; .0002) and II (P &lt; .0004) indexes. This study shows that obese people who implement daily consumption of Brazilian nuts can improve both Se status and lipid profile, especially high-density lipoprotein cholesterol levels, thereby reducing cardiovascular risks. (C) 2012 Published by Elsevier Inc.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Brazil)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil [07/50533-4]Coordenacao de Aperfeicoamento de Pessoal de Nivel SuperiorCoordenacao de Aperfeicoamento de Pessoal de Nivel Superio

Glutathione Peroxidase 1 Pro198Leu Polymorphism in Brazilian Alzheimer's Disease Patients: Relations to the Enzyme Activity and to Selenium Status

Background/Aims: Oxidative stress plays a central role in Alzheimer's disease (AD). Pro198Leu cytosolic glutathione peroxidase (GPx1) polymorphism seems to be associated with a lower activity of this enzyme, but there are no studies with AD patients. Thus, the aim was to determine the frequency of the GPx1 Pro198Leu polymorphism in AD patients and to verify its relation to glutathione peroxidase (GPx) activity and selenium (Se) status. Methods:The study was carried out in a group of AD elderly (n = 28) compared to a control group (n = 29). Blood Se concentrations were measured through hydride generation atomic absorption spectroscopy. GPx activity was determined using a commercial kit, and the polymorphism using amplified DNA sequencing. Results:The distribution of genotypes was not different between groups. The variant allele frequency was 0.179 (AD group) and 0.207 (control group). Although no differences regarding GPx activity were found between individuals with different genotypes, lower blood Se levels were found in Pro/Pro AD patients compared to Pro/Pro control subjects, which was not found in the Pro/Leu groups. Moreover, the association between the erythrocyte Se concentration and GPx activity was affected by the Pro198Leu genotype. Conclusions: Results indicate that this polymorphism had apparently affected Se status in AD patients and that more studies in this field are necessary. Copyright (c) 2012 S. Karger AG, BaselFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP